Correction: Evidence of transmission of Clostridium difficile in asymptomatic patients following admission screening in a tertiary care hospital

Sheth, Prameet M.; Douchant, Katya; Uyanwune, Yvonne; Larocque, M.; Anantharajah, Arravinth; Borgundvaag, Emily; Dales, Lorraine; McCreight, Liz; McNaught, Laura; Moore, Christine; Ragan, Kelsey; McGeer, Allison; Broukhanski, George

doi:10.1371/journal.pone.0219579

Cited by 7 publications

(1 citation statement)

References 2 publications

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“…Colon infection with the Gram-positive bacterium C difficile (CDI) can be life-threatening and almost 20 % of patients are colonised with this bacterium during hospitalisation and more than 30 % of them develop diarrhoea. [1][2][3] After the spread of highly virulent strains, mostly ribotype 027 (ribotype 027, North American pulsed-field gel electrophoresis type 1 or restriction endonuclease analysis group BI, NAP1/027/B1), an increase in the number of severe cases was noticed, as shown by studies from Europe and of North America. 4,5 Another problem is the recurrence of infection that occurs in 25 % (6 ± 42 %) of all CDI cases, endangering the health of patients even more.…”

Section: Introductionmentioning

confidence: 97%

Epidemiological and clinical characteristics of patients with healthcare: Associated Clostridioides difficile infection before and during the COVID-19 pandemic

Knežević¹,

Jović²,

Petković³

2023

Scripta Medica

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Background/Aim: Diarrhoea that occurs as a result of the presence of Clostridium difficile (reclassified as Clostridioides difficile) is usually manifested as a hospital infection, usually after antibiotic treatment. The study aim was to assess the incidence, characteristics and outcomes of hospitalised patients with healthcare - associated Clostridioides difficile infection (HA - CDI) before and during the COVID-19 pandemic. Methods: This retrospective cohort study included patients older than 18, who met the HA - CDI case definition. The CDI diagnosis was made by demonstrating toxins A and B in stool samples using an immunochromatographic assay test and polymerase chain reaction (PCR). Results: The incidence of HA - CDI has significantly decreased from the preCOVID-19 period to the COVID-19 period (11.04 per 10,000 vs 6.49 per 10,000, p < 0.001). Before establishing the HA - CDI diagnosis, 41.4 % of patients used one antibiotic, 25.9 % used two and 11.2 % were treated with three or more antibiotics. Almost one half of the applied antibiotics were from the group that represents high risk for the development of HA - CDI. Multivariable logistic regression analysis showed that older age (OR = 3.4; 95 % CI = 0.9-12.4; p = 0.038) and complicated disease course (OR = 11.8; 95 % CI = 2.6-53.6; p ≤ 0.001) were associated with a higher risk of death. Conclusion: The incidence of HA - CDI has decreased during the observed period of the COVID-19 pandemic, however, no clear connection between the impact of the pandemic and incidence reduction was found. Due to unfavourable outcome of the treatment of HA - CDI patients during COVID-19 pandemic, the rational use of antibiotics is necessary.

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Section: Introductionmentioning

confidence: 97%

Epidemiological and clinical characteristics of patients with healthcare: Associated Clostridioides difficile infection before and during the COVID-19 pandemic

Knežević¹,

Jović²,

Petković³

2023

Scripta Medica

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Infection prevention and control insights from a decade of pathogen whole-genome sequencing

Eyre

2022

Journal of Hospital Infection

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Pathogen whole-genome sequencing has become an important tool for understanding the transmission and epidemiology of infectious diseases. It has improved our understanding of sources of infection and transmission routes for important healthcare-associated pathogens, including Clostridioides difficile and Staphylococcus aureus . Transmission from known infected or colonised patients in hospitals may explain fewer cases than previously thought and multiple introductions of these pathogens from the community may play a greater a role. The findings have had important implications for infection prevention and control. Sequencing has identified heterogeneity within pathogen species, with some subtypes transmitting and persisting in hospitals better than others. It has identified sources of infection in healthcare-associated outbreaks of food-borne pathogens, Candida auris and Mycobacterium chimera , as well as individuals or groups involved in transmission and historical sources of infection. SARS-CoV-2 sequencing has been central to tracking variants during the COVID-19 pandemic and has helped understand transmission to and from patients and healthcare workers despite prevention efforts. Metagenomic sequencing is an emerging technology for culture-independent diagnosis of infection and antimicrobial resistance. In future, sequencing is likely to become more accessible and widely available. Real-time use in hospitals may allow infection prevention and control teams to identify transmission and to target interventions. It may also provide surveillance and infection control benchmarking. Attention to ethical and well-being issues arising from sequencing identifying individuals involved in transmission is important. Pathogen whole-genome sequencing has provided an incredible new lens to understand the epidemiology of healthcare-associated infection and to better control and prevent these infections.

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Anti-virulence strategies for Clostridioides difficile infection: advances and roadblocks

2020

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Clostridioides difficile infection (CDI) is a common healthcare- and antibiotic-associated diarrheal disease. If mis-diagnosed, or incompletely treated, CDI can have serious, indeed fatal, consequences. The clinical and economic burden imposed by CDI is great, and the US Centers for Disease Control and Prevention has named the causative agent, C. difficile (CD), as an Urgent Threat To US healthcare. CDI is also a significant problem in the agriculture industry. Currently, there are no FDA-approved preventives for this disease, and the only approved treatments for both human and veterinary CDI involve antibiotic use, which, ironically, is associated with disease relapse and the threat of burgeoning antibiotic resistance. Research efforts in multiple laboratories have demonstrated that non-toxin factors also play key roles in CDI, and that these are critical for disease. Specifically, key CD adhesins, as well as other surface-displayed factors have been shown to be major contributors to host cell attachment, and as such, represent attractive targets for anti-CD interventions. However, research on anti-virulence approaches has been more limited, primarily due to the lack of genetic tools, and an as-yet nascent (but increasingly growing) appreciation of immunological impacts on CDI. The focus of this review is the conceptualization and development of specific anti-virulence strategies to combat CDI. Multiple laboratories are focused on this effort, and the field is now at an exciting stage with numerous products in development. Herein, however, we focus only on select technologies (Figure 1) that have advanced near, or beyond, pre-clinical testing (not those that are currently in clinical trial), and discuss roadblocks associated with their development and implementation.

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Correction: Evidence of transmission of Clostridium difficile in asymptomatic patients following admission screening in a tertiary care hospital

Cited by 7 publications

References 2 publications

Epidemiological and clinical characteristics of patients with healthcare: Associated Clostridioides difficile infection before and during the COVID-19 pandemic

Epidemiological and clinical characteristics of patients with healthcare: Associated Clostridioides difficile infection before and during the COVID-19 pandemic

Infection prevention and control insights from a decade of pathogen whole-genome sequencing

Anti-virulence strategies for Clostridioides difficile infection: advances and roadblocks

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